Postlaminectomy cervical dislocation in von Recklinghausen's disease. A case report.
METHODS
A case of a 9-year-old girl with von Recklinghausen's disease who has acute tetraparesis caused by a complete dislocation of C6-C7 after a cervical laminectomy performed at another hospital.


OBJECTIVE
To demonstrate the treatment difficulties of cervical spine abnormality associated with neurofibromatosis.


BACKGROUND
Craig and Govender have reported cases of neurofibromatosis of the cervical spine (1992).


METHODS
The patient underwent emergency surgery starting with a posterior release of the articular facets and with the positioning of two Roy-Camille plates. The dislocation of C6-C7 was reduced by an anterior approach. Finally the Roy-Camille plates were removed, a plate was implanted posteriorly at the C6 and C7 joints, and a posterior cable was positioned around the C2-C3 posterior arches.


RESULTS
More than 4.5 years after surgery, the patient's neurologic condition remains satisfactory. She can walk and run and has no sphincter disorders.


CONCLUSIONS
The results underline the importance of simultaneous anterior and posterior surgical approaches in this disease.
Gioia
G
G
IV Department of Orthopaedic Surgery, University of Milan Medical School, IRCSS H. San Raffaele, Italy.
Mandelli
D
D
Capaccioni
B
B
Sartori
A
A
D001860:Bone Plates; D002648:Child; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D009333:Neck; D009456:Neurofibromatosis 1 / Q000150:complications*; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*